The Robert Wood Johnson Foundation (RWJF) today announced the selection of 16 hospitals to participate in the first two cohorts of the Aligning Forces for Quality: Transforming Care at the Bedside Collaborative (TCAB Collaborative). The collaborative engages nurses and other frontline staff to improve the quality and safety of patient care on medical and surgical units in hospitals.

The TCAB Collaborative is part of RWJF’s Aligning Forces for Quality (AF4Q) initiative, a cornerstone of the Foundation’s $300-million commitment to improving quality in regions across the United States. Hospitals from 14 AF4Q communities applied to be part of the TCAB Collaborative. The collaborative is based on TCAB programs launched by RWJF and the Institute for Healthcare Improvement in 2003. Hospitals that have already participated in TCAB report a cultural shift on their medical-surgical units that has produced better clinical outcomes, more time spent with patients, reduced nurse turnover and lower costs.

Experts say TCAB is not a traditional quality improvement program because of its primary focus on engaging nurses and other frontline staff to develop and lead the quality improvement efforts. Ideas for transforming care come not from the hospital’s executive suite or quality improvement staff, but from those who spend the most time providing direct care to patients. Nurse-led teams identify where change is needed on their unit, suggest and test potential solutions, and decide whether and how those innovations should be implemented.

“Empowering frontline staff—particularly nurses—to improve the processes of care delivery is one of the key features of the TCAB Collaborative,” said John R. Lumpkin, M.D., M.P.H., senior vice president and director of the health care group at the Robert Wood Johnson Foundation. “Since nurses work closest to the patient, they have the unique opportunity to best identify how to make things work better in order to provide better, safer quality care.”

Led by RWJF, the TCAB Collaborative will be overseen by the Center for Health Care Quality at The George Washington University Medical Center School of Public Health and Health Services, which serves as the national program office for the Aligning Forces for Quality initiative. Technical assistance will be provided by the American Organization of Nurse Executives. The Institute for Healthcare Improvement will convene training workshops for participants. The first cohort will kick-off this month and the second cohort launches fall of 2009.

In every region involved in the Aligning Forces for Quality initiative, broad-based teams of people who get care, give care and pay for care are working together to improve health care quality. These alliances include participation from physicians, nurses, patients, consumers and consumer groups, purchasers, hospitals, health plans, safety net providers, and others. By aligning people from across the community in different AF4Q initiatives, RWJF hopes to help achieve communitywide transformation of health care.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.